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Patient Education Process in Oncologic Context

What, Why, and by Whom?

Vaartio-Rajalin, Heli; Huumonen, Tuula; Iire, Liisa; Jekunen, Antti; Leino-Kilpi, Helena; Minn, Heikki; Paloniemi, Jenni

doi: 10.1097/NNR.0000000000000114

Background Patients with cancer move between institutions and settings and have different knowledge expectations during their illness trajectory. To provide individually tailored, timely, and relevant education, healthcare professionals should collaborate in the patient education process.

Objectives This study aimed to describe procedures used by healthcare professionals involved in cancer management when assessing knowledge expectations, cognitive resources, and comprehension of adult patients with cancer during and after education in various phases of their illness trajectory. Intraprofessional and interprofessional collaboration concerning the patient education process is described.

Methods Eleven focus group interviews were conducted for nurses (n = 42) and physicians (n = 23) involved in cancer care from four healthcare organizations: a private occupational health care and three hospital settings. Interview data were analyzed with inductive content analysis.

Results In the assessment of the knowledge expectations, cognitive resources, and comprehension of a patient with cancer, both the nurses and physicians first applied objective assessment methods and then used dialogue with the patient. No validated instruments were used by either group. Among nurses, educational content was based on the patient’s possible or actual problems in everyday life during cancer management, whereas the physicians focused on the patient’s rights to information and informed consent for treatment. The patient education process was often incompletely documented into patient records and not always utilized interprofessionally or between care units.

Discussion In oncology services, there is a gap between research evidence utilization and the patient education process. Patients should be involved in the planning, implementation, and evaluation of their education and be informed about the division of responsibilities in patient education between different professional groups. This would allow patients to participate more extensively in the decision making concerning their own treatments. To ensure effective interprofessional patient education for individual patients, improvement in information exchange among members of the cancer care team is needed.

Heli Vaartio-Rajalin, RN, PhD, is Researcher, Department of Nursing Science, University of Turku, Finland.

Tuula Huumonen, RN, is Head Nurse, Oncologic Clinic, Satakunta Hospital, Pori, Finland.

Liisa Iire, RN, PhD, is Head Nurse, Oncologic Clinic, University Hospital of Turku, Finland.

Antti Jekunen, PhD, MD, is Professor and Chief Physician, Oncology Clinic, Vaasa Central Hospital, Finland.

Helena Leino-Kilpi, RN, PhD, FEANS, is Professor, Department of Nursing Science, University of Turku, and Nurse Director, Turku University Hospital, Finland.

Heikki Minn, MD, is Chief Physician, Oncologic Clinic, University Hospital of Turku, Finland.

Jenni Paloniemi, RN, is Ward Sister, Oncologic Clinic, Vaasa Hospital, Finland.

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Accepted for publication June 11, 2015.

The authors acknowledge that funding was received from the Finnish Nurses Association.

The authors declare no conflicts of interest.

Corresponding author: Heli Vaartio-Rajalin, Saukonkatu 10 a 3, 20760 Piispanristi, Finland (e-mail:

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved